Grant Application Form

Grant Application Form
Date

MonthDayYear
Applicant Information
Name of Organization*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal Code
Phone Number*

Area CodePhone Number
Fax

Area CodePhone Number
E-mail*
Diocesan affiliation (if any)
Are you a registered charity?*

YesNo
CRA Registration Number*
Names of Directors*
Names of Officers*
Name of Manager or CEO*

First NameLast Name
Nature, objectives, and brief history of the applicant*
Financial Statements for last year*
Acceptable formats: DOC, PDF, XLS
Budget for current year*
Acceptable formats: DOC, PDF, XLS
Project or Service Information
Amount of Grant Requested*
Description on project or service (intended use)*
The application must be signed by the President/Chief Executive Officer of the applying organization. Please enter their name below. The named executive must digitally sign in the appropriate space.
Executive Name*

First NameLast Name
Executive Title*
Executive Signature*

Clear
Please provide the name of an individual with your organization from whom further information may be obtained:
Contact Name*

First NameLast Name
Contact Title*
Contact Phone Number*

Area CodePhone Number
Should be Empty:

Applicant Information